Dependent Children Join FEHBP

The number of people covered by the Federal Employee Health Benefits Program is expected to jump dramatically next year and the number of people switching from self-only to family coverage will also go up.

Those eligible for FEHBP coverage will include dependent children and foster children up to age 26 who are not living with their federal parents.

The FEHBP cradle-to-grave program is the biggest (and many say best) employer-provided health care system in the nation. It covers nearly 9 million individuals from young healthy letter carriers, IRS agents, astronauts, CIA staffers and U.S. Senators to 100 year old retirees or their surviving spouses. It some cases it also covers the divorced spouses of federal workers or retirees.

The government pays the lion’s share (about 72 percent) of the total premiums and workers and retirees can switch plans each year (or more often in some cases) to seek out better benefits or better premiums. Unlike many private sector health plans which reduce benefits or drop retirees altogether, the FEHBP is forever.

The FEHBP offers workers, retirees and eligible dependents the choice of more than a dozen plans and options. Active workers and retirees (and survivors) pay the same premiums in the same plans. There is no age penalty and nobody can be rejected by any plan because of age, health or pre-existing condition.

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Beginning next year federal and postal workers (and retirees) will for the first time be able to insure dependent children up to age 26 as part of their FEHBP family plan. Currently dependent children (unless they are permanently disabled) must leave the federal program shortly after their 22nd birthday.

In the past many, if not most, nondisabled dependent children who qualified for FEHBP coverage were in college. But because of the economic downturn many young adults who’ve lost or can’t find jobs are back home. And on the family budget.

President Obama’s Affordable Care Act (passed earlier this year) extended dependent coverage to age 26 for private sector plans. But because the FEHBP is controlled by Congress, special legislation would have been required to change the 22-to-26 rule. Bills to that effect were introduced, but Congress has had other priorities (including lots of time off) and didn’t get around to making the change for the federal program. But effective next year, all plans will be required to cover dependent children up to age 26.

Here are the changes effective in January, 2011:

Children up to age 26 will be covered under their parent’s family FEHBP plan up to age 26.

Married children, but not their spouse, will also be covered up to age 26.

Children who are eligible for and/or who have their own employer-provided health coverage are also eligible for the FEHBP (as part of their parent’s family plan) through age 26. If they keep their non-federal employer-provided health plan it will become the primary payer and FEHBP will be the secondary payer.

Stepchildren, whether they live with the FEHBP policy-holder or not, will be eligible for coverage up to age 26.

Children incapable of supporting themselves because of a physical or mental disability that began before age 26 are eligible to continue coverage indefinitely.

Foster children will also be eligible for FEHBP coverage (under a family plan) up to age 26.

The open enrollment benefits period for year 2011 coverage begins November 8 and runs through Dec. 13 of this year. That’s when people can change plans for next year and/or add dependent children up to age 26 for coverage in 2011.

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